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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 7
Jul.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(7): 1364-1370

Influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis

DOI: 10.12449/JCH250721
  • 1.

    Yunnan Provincial Clinical Medical Center for Infectious Diseases，The Third People’s Hospital of Kunming，Kunming 650054，China

  • 2.

    School of Public Health，Dali University，Dali，Yunnan 371000，China

Research funding:

Yunnan Province Science and Technology Plan Project (2017FH001-088);

Health Research Project of Kunming Health Commission (2022-03-08-008)

More Information
  • Corresponding author: LIU Li， liuli197210@163.com （ORCID： 0000-0001-7712-4931）
  • Received Date: 2024-11-04
  • Accepted Date: 2024-11-21
  • Published Date: 2025-07-25
    Abstract
  •   Objective  To investigate the influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis， and to establish a predictive model.  Methods  A total of 517 patients who attended The Third People’s Hospital of Kunming and were diagnosed with decompensated hepatitis B cirrhosis from January 1， 2016 to December 31， 2022 were enrolled. The clinical data of the patients were reviewed， and the 207 patients with no portal hypertension-related complications within at least 1 year were enrolled as recompensation group， while the 310 patients without recompensation were enrolled as persistent decompensation group. Related clinical data were collected， and the univariate and multivariate Cox regression analyses were performed for the factors that might affect the occurrence of recompensation. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The “rms” package was used to establish a nomogram； the receiver operating characteristic （ROC） curve was plotted， and the area under the ROC curve （AUC） was calculated； the Hosmer-Lemeshow test was used to evaluate the degree of fitting of the model； the “Calibration Curves” package was used to plot the calibration curve for model assessment.  Results  Among the patients with decompensated hepatitis B cirrhosis， 207 （40.03%） had recompensation. The univariate Cox regression analysis showed that there were significant differences between the recompensation group and the persistent decompensation group in TIPS history， genotyping， portal vein thrombosis， complicated infection， Child-Pugh class， age， hemoglobin （Hb）， platelet count， total protein， albumin （Alb）， alanine aminotransferase， triglyceride， cholesterol， creatinine， Na， interleukin-6， high-sensitivity C-reactive protein， portal vein width， and portal vein velocity （all P<0.05）. The multivariate regression analysis showed that TIPS history （hazard ratio ［HR］=2.491， 95% confidence interval ［CI］： 1.325‍ ‍—‍ ‍4.681， P=0.005）， portal vein thrombosis （HR=0.345， 95%CI： 0.152‍ ‍—‍ ‍0.783， P=0.001）， Hb （HR=1.007， 95%CI： 1.000‍ ‍—‍ ‍1.013， P=0.028）， Alb （HR=1.048， 95%CI： 1.017‍ ‍—‍ ‍1.080， P=0.002）， and portal vein width （HR=0.899， 95%CI： 0.835‍ ‍—‍ ‍0.967， P=0.004） were independent influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis. A nomogram model was established based on the above five influencing factors， and the Hosmers-Lemeshow test showed that this model had a good degree of fitting （χ²=3.202， P=0.921）. The nomogram model had an AUC of 0.728， a sensitivity of 50.3%， and a specificity of 85.0%， and the calibration curve showed good consistency between the actual value of this model in predicting the occurrence of recompensation and the predicted value in patients with decompensated hepatitis B cirrhosis.  Conclusion  Patients with decompensated hepatitis B cirrhosis who have a history of TIPS and high levels of Alb and Hb are more likely to have recompensation， and it is relatively difficult for patients with portal vein thrombosis and an increase in portal vein width to achieve recompensation.

     

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